Renal venous thrombosis in infants and children
M. A. Ricci and D. A. Lloyd
Division of Pediatric Surgery, University of Pittsburgh School of Medicine, Pa.
Urgent nephrectomy was once considered standard therapy for renal venous
thrombosis, but recently nonoperative therapy has been advised. To examine
this trend more closely, we reviewed 46 cases of renal venous thrombosis
seen at the Children's Hospital of Pittsburgh (Pa) over the last 32 years.
Earlier, diagnosis was frequently supported by intravenous pyelography,
which was 79% accurate. More recently, sonography confirmed the diagnosis
with 92% accuracy. Of 21 patients diagnosed during life, 4 were treated
operatively and 3 survived. Of 17 patients treated nonoperatively, 14 (82%)
survived, including 5 with bilateral disease. Since 1978, of the 10
patients treated nonoperatively, 9 have survived with no long-term
morbidity. Our experience confirms that early diagnosis with sonography
followed by supportive nonoperative therapy offers the best chance for
success in patients with renal venous thrombosis.
